N. Sriram

National differences in gender–science stereotypes predict national sex differences in science and math achievement

About 70% of more than half a million Implicit Association Tests completed by citizens of 34 countries revealed expected implicit stereotypes associating science with males more than with females. We discovered that nation-level implicit stereotypes predicted nation-level sex differences in 8th-grade science and mathematics achievement. Self-reported stereotypes did not provide additional predictive validity of the achievement gap. We suggest that implicit stereotypes and sex differences in science participation and performance are mutually reinforcing, contributing to the persistent gender gap in science engagement.

Understanding and Using the Brief Implicit Association Test: Recommended Scoring Procedures

A brief version of the Implicit Association Test (BIAT) has been introduced. The present research identified analytical best practices for overall psychometric performance of the BIAT. In 7 studies and multiple replications, we investigated analytic practices with several evaluation criteria: sensitivity to detecting known effects and group differences, internal consistency, relations with implicit measures of the same topic, relations with explicit measures of the same topic and other criterion variables, and resistance to an extraneous influence of average response time. The data transformation algorithms D outperformed other approaches. This replicates and extends the strong prior performance of D compared to conventional analytic techniques. We conclude with recommended analytic practices for standard use of the BIAT.

Reducing Implicit Gender Leadership Bias in Academic Medicine With an Educational Intervention

Purpose One challenge academic health centers face is to advance female faculty to leadership positions and retain them there in numbers equal to men, especially given the equal representation of women and men among graduates of medicine and biological sciences over the last 10 years. The purpose of this study is to investigate the explicit and implicit biases favoring men as leaders, among both men and women faculty, and to assess whether these attitudes change following an educational intervention. Method The authors used a standardized, 20-minute educational intervention to educate faculty about implicit biases and strategies for overcoming them. Next, they assessed the effect of this intervention. From March 2012 through April 2013, 281 faculty members participated in the intervention across 13 of 18 clinical departments. Results The study assessed faculty members’ perceptions of bias as well as their explicit and implicit attitudes toward gender and leadership. Results indicated that the intervention significantly changed all faculty members’ perceptions of bias (P < .05 across all eight measures). Although, as expected, explicit biases did not change following the intervention, the intervention did have a small but significant positive effect on the implicit biases surrounding women and leadership of all participants regardless of age or gender (P = .008). Conclusions These results suggest that providing education on bias and strategies for reducing it can serve as an important step toward reducing gender bias in academic medicine and, ultimately, promoting institutional change, specifically the promoting of women to higher ranks.

Overweight People Have Low Levels of Implicit Weight Bias, but Overweight Nations Have High Levels of Implicit Weight Bias

Although a greater degree of personal obesity is associated with weaker negativity toward overweight people on both explicit (i.e., self-report) and implicit (i.e., indirect behavioral) measures, overweight people still prefer thin people on average. We investigated whether the national and cultural context – particularly the national prevalence of obesity – predicts attitudes toward overweight people independent of personal identity and weight status. Data were collected from a total sample of 338,121 citizens from 71 nations in 22 different languages on the Project Implicit website (https://implicit.harvard.edu/) between May 2006 and October 2010. We investigated the relationship of the explicit and implicit weight bias with the obesity both at the individual (i.e., across individuals) and national (i.e., across nations) level. Explicit weight bias was assessed with self-reported preference between overweight and thin people; implicit weight bias was measured with the Implicit Association Test (IAT). The national estimates of explicit and implicit weight bias were obtained by averaging the individual scores for each nation. Obesity at the individual level was defined as Body Mass Index (BMI) scores, whereas obesity at the national level was defined as three national weight indicators (national BMI, national percentage of overweight and underweight people) obtained from publicly available databases. Across individuals, greater degree of obesity was associated with weaker implicit negativity toward overweight people compared to thin people. Across nations, in contrast, a greater degree of national obesity was associated with stronger implicit negativity toward overweight people compared to thin people. This result indicates a different relationship between obesity and implicit weight bias at the individual and national levels.

No Measure Is Perfect, but Some Measures Can be Quite Useful

The comment articles in this issue by Friese and Fiedler (F&F) and by Rothermund and Wentura (R&W) offer perspectives on the validity of the Brief Implicit Association Test (BIAT) (Sriram & Greenwald, 2009; S&G). F&F concluded that construct validity of the BIAT can be established only by conducting studies that experimentally manipulate association strengths. We suggest that this conclusion overvalues experimental strategies and undervalues correlational validation strategies. R&Ws critique was predicated on their use of a semantic-network theoretical understanding of the concept of association. In contrast, S&G offered the BIAT as a technique for measuring association strengths in the context of a broader concept of association that has roots in antiquity--and remains widely used in psychology. With this broader understanding of association, some of the phenomena that R&W treated as threats to the BIATs validity are viewed, instead, as contributors to its validity.

Attitudes and Stereotypes in Lung Cancer versus Breast Cancer.

Societal perceptions may factor into the high rates of nontreatment in patients with lung cancer. To determine whether bias exists toward lung cancer, a study using the Implicit Association Test method of inferring subconscious attitudes and stereotypes from participant reaction times to visual cues was initiated. Participants were primarily recruited from an online survey panel based on US census data. Explicit attitudes regarding lung and breast cancer were derived from participants’ ratings (n = 1778) regarding what they thought patients experienced in terms of guilt, shame, and hope (descriptive statements) and from participants’ opinions regarding whether patients ought to experience such feelings (normative statements). Participants’ responses to descriptive and normative statements about lung cancer were compared with responses to statements about breast cancer. Analyses of responses revealed that the participants were more likely to agree with negative descriptive and normative statements about lung cancer than breast cancer (P<0.001). Furthermore, participants had significantly stronger implicit negative associations with lung cancer compared with breast cancer; mean response times in the lung cancer/negative conditions were significantly shorter than in the lung cancer/positive conditions (P<0.001). Patients, caregivers, healthcare providers, and members of the general public had comparable levels of negative implicit attitudes toward lung cancer. These results show that lung cancer was stigmatized by patients, caregivers, healthcare professionals, and the general public. Further research is needed to investigate whether implicit and explicit attitudes and stereotypes affect patient care.

Challenges in the development of an immunochromatographic interferon-gamma test for diagnosis of pleural tuberculosis.

Existing diagnostic tests for pleural tuberculosis (TB) have inadequate accuracy and/or turnaround time. Interferon-gamma (IFNg) has been identified in many studies as a biomarker for pleural TB. Our objective was to develop a lateral flow, immunochromatographic test (ICT) based on this biomarker and to evaluate the test in a clinical cohort. Because IFNg is commonly present in non-TB pleural effusions in low amounts, a diagnostic IFNg-threshold was first defined with an enzyme-linked immunosorbent assay (ELISA) for IFNg in samples from 38 patients with a confirmed clinical diagnosis (cut-off of 300pg/ml; 94% sensitivity and 93% specificity). The ICT was then designed; however, its achievable limit of detection (5000pg/ml) was over 10-fold higher than that of the ELISA. After several iterations in development, the prototype ICT assay for IFNg had a sensitivity of 69% (95% confidence interval (CI): 50-83) and a specificity of 94% (95% CI: 81-99%) compared to ELISA on frozen samples. Evaluation of the prototype in a prospective clinical cohort (72 patients) on fresh pleural fluid samples, in comparison to a composite reference standard (including histopathological and microbiologic test results), showed that the prototype had 65% sensitivity (95% CI: 44-83) and 89% specificity (95% CI: 74-97). Discordant results were observed in 15% of samples if testing was repeated after one freezing and thawing step. Inter-rater variability was limited (3%; 1out of 32). In conclusion, despite an iterative development and optimization process, the performance of the IFNg ICT remained lower than what could be expected from the published literature on IFNg as a biomarker in pleural fluid. Further improvements in the limit of detection of an ICT for IFNg, and possibly combination of IFNg with other biomarkers such as adenosine deaminase, are necessary for such a test to be of value in the evaluation of pleural tuberculosis.

Presenting Survey Items One at a Time Compared to All at Once Decreases Missing Data without Sacrificing Validity in Research with Internet Volunteers

In two large web-based studies, across five distinct criteria, presenting survey items one-at-a-time was psychometrically either the same or better than presenting survey items all-at-once on a single web page to volunteer participants. In the one-at-a-time format, participants were no more likely to drop-out of the study (Criterion 1), and were much more likely to provide answers for the survey items (Criterion 2). Rehabilitating participants who otherwise would not have provided survey responses with the one-at-a-time format did not damage internal consistency of the measures (Criterion 3) nor did it negatively affect criterion validity (Criterion 4). Finally, the one-at-a-time format was more efficient with participants completing it more quickly than the all-at-once format (Criterion 5). In short, the one-at-a-time format results in less missing data with a shorter presentation time, and ultimately more power to detect relations among variables.